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Introduction: Effective pain management is crucial in the emergency department (ED), particularly for trauma patients. Ultrasound-guided regional analgesia (UGRA) has emerged as a promising technique for acute pain relief. The objective of this study is to describe the various UGRA performed and assess their effectiveness among trauma patients in our Level 1 Trauma Center ED over the past 2.5 years. Methods: Data from 485 trauma patients who underwent UGRA over 2.5 years were analyzed retrospectively. The primary outcome was the median Defense and Veterans Pain Rating Scale (DVPRS) reduction at 30 min and 1 h after nerve block administration. Patient characteristics, types of nerve blocks administered, procedural details, and outcomes were also noted. Statistical analysis was performed to determine the median reduction in pain scores and evaluate the success of UGRA. Results: UGRA demonstrated a significant reduction in pain scores, with a median DVPRS decrease from 9 (interquartile range [IQR]: 9–10) preprocedure to 4 (IQR: 2–5) at 30 min and 1 (IQR: 0–2) at 1 h postprocedure. Sixteen types of nerve blocks were administered in our ED, with the serratus anterior block (n = 91) and fascia iliaca compartment block (n = 58) being the most common. Pain relief was the most common indication for block administration. A higher volume was injected for plane blocks compared to nerve-specific blocks. No complications or failed blocks were reported. Conclusion: This study describes 16 different UGRA that can be performed by emergency physicians (EPs) in ED for trauma patients. UGRA is effective in providing substantial pain relief for trauma patients in the ED. UGRA performed by EPs offers a safe and feasible approach for managing acute pain in the ED. [ABSTRACT FROM AUTHOR]

Bee sting can lead to allergic reactions which can present as life-threatening emergencies. Kounis syndrome is an acute coronary syndrome caused by mast cell activation after exposure to an allergen. Atrial fibrillation (AF) along with Kounis syndrome after allergen exposure is a rare presentation. A 40-year-old male patient presented to the emergency department (ED) with multiple bee stings to the face and neck. He complained of retrosternal chest pain along with facial pain and swelling. An electrocardiogram (ECG) showed AF with ST elevation in aVR and generalized ST segment depression. Troponin levels were elevated. He was diagnosed with Kounis syndrome along with AF secondary to a bee sting. The patient improved symptomatically with removal of stings and conservative management (steroids, antihistamines, antiplatelet drugs). ECG reverted to sinus rhythm and resolution of ST-T changes. He was discharged from the ED in stable condition. The bee sting may lead to significant cardiovascular events such as AF and Kounis syndrome, which require a high index of suspicion and prompt treatment. Kounis syndrome should be suspected in the ED in young patients with no cardiovascular risk factors after exposure to an allergen. [ABSTRACT FROM AUTHOR]